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Fagan Residence
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Elmont, New York
NPI 1730209362

Fagan Residence is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Elmont, NY. Fagan Residence practices in Elmont, NY. The NPI Number for Fagan Residence is 1730209362 and holds a License No. 6186445 (New York).

The current practice location address for Fagan Residence is 1504 Depaul St, Elmont, NY and can be reached out via phone at 631-665-3434.

Location: 1504 Depaul St, Elmont, NY, 11003-1900
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1730209362
Provider Name
Fagan Residence
Credential
Provider Entity Type
Organization
Address
1504 Depaul St, Elmont, NY, 11003-1900
Phone Number
631-665-3434
Fax Number
Provider Enumeration Date
03/29/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02245930 05 NY
institution
Provider Business Practice Location Address Details
Address
1504 Depaul St
City
Elmont
State
New York
Zip
11003-1900
Phone Number
631-665-3434
Fax Number
person
Provider Business Mailing Address Details
Address
1504 Depaul St
City
Elmont
State
New York
Zip
11003-1900
Phone Number
631-665-3434
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
6186445 (New York)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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